The business of survival: Generic medicines at the intersection of health, policy, and structural resilience in Lebanon

Lebanon has faced a series of overlapping crises, including a severe financial collapse, the pandemic, the Beirut port explosion, the removal of subsidies, electricity shortages, and, most recently, the war in Lebanon. These events have disrupted supply chains, led to currency devaluation, damaged infrastructure, and generated market instability, ultimately resulting in critical medicine shortages, price volatility, and reduced availability of essential pharmaceuticals. These crises’ compounded effects have placed immense pressure on the healthcare system and heightened population reliance on generic medicines. This study maps the pathways linking multiple crises to medicine access challenges, highlighting both direct and indirect impacts on the pharmaceutical supply. Using a structured framework, we identify key vulnerabilities and the resulting adaptations in healthcare provision. Central to the response is the strategic promotion of generic medicines as a resilience mechanism to mitigate shortages and maintain treatment continuity. Findings underscore the importance of proactive, system-level strategies to buffer health systems against multifactorial shocks. By integrating crisis mapping with targeted interventions, policymakers and healthcare providers can enhance preparedness, ensure the availability of medicine, and strengthen resilience in the face of ongoing socio-political and economic instability. This approach offers a practical model for other regions facing compounded crises that impact healthcare access.